Charlottesville, VA 22911 · CMS Certification Number 490077. What Medicare pays this hospital for knee, hip and shoulder replacement, what it lists, how it compares, and what a surgery center nearby is paid.
| Operation | Inpatient paid | List price | List ÷ paid | Outpatient allowed |
|---|---|---|---|---|
| Hip or knee replacement | $13,484 | $41,178 | 3.1× | $11,196 |
| Shoulder replacement | — | — | — | $15,787 |
| Hip replacement after a fracture (DRG 522) | $13,529 | $49,259 | 3.6× | — |
Complications after hip or knee replacement: 4.9% (no different from the national rate). Readmissions: 5.9%. Overall Care Compare rating: 4 of 5 stars. Nonprofit · Acute · 176 beds
Virginia requires a certificate of need for new surgery centers.
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In 2024 Medicare paid Sentara Martha Jefferson Hospital an average of $13,484 per inpatient hip or knee replacement stay (MS-DRG 470, 22 stays) and $11,196 per outpatient case (APC 5115, 372 cases).
The hospital's average list (chargemaster) price for an inpatient hip or knee replacement was $41,178, 3.1× what Medicare paid. Almost nobody pays the list price; it matters for uninsured bills and percent-of-charge contracts.
Yes for Medicare facility payments. Soaring Surgery Center, an orthopedic surgery center same ZIP away, is paid about $8,552 by Medicare for a knee replacement (CPT 27447), $4,932 less than an inpatient stay at Sentara Martha Jefferson Hospital. Not every patient is a surgery-center candidate.
Medicare paid Sentara Martha Jefferson Hospital less than 82% of the 34 Virginia hospitals that report inpatient hip or knee replacement.